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Thus, the overall finding of this Report is clear: Cigarette smoking should be considered the most important of the known modifiable risk factors for coronary heart disease in the United States The first major prospective study results were made public in 1954 in the United States by Hammond and Horn and found a strong association between cigarette use among men and coronary heart disease (CHD)

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The researchers recommended that psychiatric hospitals be made smoke-free to avoid detrimental effects on mental health